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HPB Surgery
Volume 4 (1991), Issue 1, Pages 69-79
http://dx.doi.org/10.1155/1991/91486

Surgical Treatment of Giant Cavernous Hemangioma Liver

1Dept. Surgical Gastroenterology, Vishnevsky Institute of Surgery, Academy of Medical Sciences, USA
2Block 12/Flat 10, MIG (11), Baghlingampally, Hyderabad 500 044, India
3Dept. Computed Tomography, Vishnevsky Institute of Surgery, Academy of Medical Sciences, USA
4Dept. Interventional Radiology, Vishnevsky Institute of Surgery, Academy of Medical Sciences, USA

Received 5 November 1990; Accepted 5 November 1990

Copyright © 1991 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In the past five years, 16 adults (10 females, age 25–61 years, mean 48) with giant cavernous hemangioma of the liver measuring 15–31 cm (mean-19) underwent surgery in a single Institution. Diagnosis was made with the help of multimodal investigations– ultrasound (US), computed tomography (CT), hepatic angiography, hepatic scintigraphy and fine needle biopsy. Ultrasound and CT had sensitivities of 69% and 82% respectively. Fourteen had preoperative selective hepatic artery embolization to study its effect on operative blood loss. Indication for surgery in all cases was a large abdominal mass with varying severity of pain. In addition, 5 had hemetological and/or coagulation abnormalities, hemobilia in and pyrexia in 1. Seven left lobectomies, 3 left lateral segmentectomies, 2 right lobectomies, 2 right trisegmentectomies and 4 non-anatomical resections of to 3 segments were performed. Postoperative complications developed in 25% with no operative mortality. Preoperative selective hepatic artery embolization helped to decrease the operative hemorrhage in 13 (mean blood loss– 1146 ml). In two cases severe bleeding required use of Cell-saver and massive donor blood transfusion. Our results suggest use of preoperative selective hepatic artery embolization and Cell-saver as an adjunct to the liver resection for these vascular tumors.